MEDICARE: DR. AJMAL HAMEED M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	ME0085621	FL

General Provider Information

NPI Number	:	1285628388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AJMAL HAMEED M.D.

Provider Business Mailing Address
First Line	:	2151 RIVERSIDE AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-4416
Country	:	US
Telephone Number	:	904-388-8686
Fax Number	:	904-387-2659

Provider Business Practice Location Address
First Line	:	3627 UNIVERSITY BLVD S
Second Line	:	STE 430
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4230
Country	:	US
Telephone Number	:	904-858-9700
Fax Number	:	904-858-9977

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	09/27/2016

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